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Is Leg Length Discrepancy Associated With the Side of Radiating Pain in Patients With a Lumbar Herniated Disc?

ten Brinke, Albert, PT*; van der Aa, Hans E., MD, PhD; van der Palen, Job, PhD; Oosterveld, Frits, PT, PhD*

Diagnostics

Study Design. The association between leg length discrepancy and the side of the radiating pain in lumbar disc herniation was investigated in a case series.

Objectives. To investigate whether pain tends to radiate into the longer or shorter leg in patients with a lumbar herniated disc.

Summary of Background Data. No previous studies have investigated the association between leg length discrepancy and side of radiating pain in patients with a herniated disc. Results of studies of low back pain with radiation and leg length discrepancy are inconsistent concerning this association.

Methods. Of 132 consecutive patients admitted to a district hospital for surgical management of a lumbar herniated disc, leg length discrepancy was assessed using the indirect method as described by Calliet.

Results. Seventy-three patients (55%) were men, and 59 (45%) were women. The mean age was 40 years, and 99% of all herniated discs appeared at L4-L5 (n = 60) or L5-S1 (n = 71). In 64 (62%) of the 104 patients with a leg length discrepancy of 1 mm or more, the pain radiated in the shorter leg (P = 0.02). In subgroups of patients with larger leg length discrepancies, similar results were found but because of smaller sample sizes, these findings did not reach statistical significance. In 32 of the 57 men (56.1%), the pain radiated to the shorter leg (P = 0.43); this was observed in 33 of the 47 women (70.2%; P = 0.01).

Conclusion. The results of this study showed a statistically significant association between leg length discrepancy and the side of radiating pain in a case series of patients with lumbar herniated discs. The relation was more pronounced and statistically significant in women only.

From the Departments of *Physical Therapy, †Neurosurgery, and ‡Epidemiology, Medisch Spectrum Twente, Enschede, the Netherlands.

Parts of this study presented at meeting of the World Congress of Low Back Pain, San Diego, California, November 9-11, 1995.

Acknowledgment date: October 29, 1997.

First revision date: February 11, 1998.

Acceptance date: August 6, 1998.

Device status category: 1.

Address reprint requests to: Albert ten Brinke, PT; Medisch Spectrum Twente, Department of Physical Therapy; PO Box 50000; 7500 KA Enschede; The Netherlands.

© 1999 Lippincott Williams & Wilkins, Inc.